Health IT will provide job security for the foreseeable future

Hospitals nationwide are racing against the clock to ensure their health IT systems meet meaningful use guidelines.

The incentive? Money, of course. Systems that meet certain criteria make doctors eligible for up to $44,000 in bonus money from the government.

As mentioned on this blog previously, implementing an electronic health system is difficult. The usability of the current generation of EHRs is still relatively primitive, especially when compared to other industries, and the disruption in workflow is undeniable.

Worse, there seems to be a lack of trained IT professionals to do the job.

In a recent piece from American Medical News,

60% of hospital IT executives believe tech staffing shortages, which some estimate to be a shortfall of 50,000 qualified IT professionals, will definitely or possibly affect their chances to achieve meaningful use.

It’s a problem.

And what about small, independent practices that may not have the budget for a health IT staff? They’re likely to run into additional trouble, as well. Not only is health IT staff difficult to find, “Apparently, EHR vendors may be overwhelmed by the demand meaningful use may bring.”

It appears that, even if doctors are willing to adopt EHRs and go digital, the limiting factor may not only be money, but finding the appropriate technical support personnel to do the job.

If you’re looking for work, health IT is likely to provide reasonable job security for the foreseeable future.

Physician Coaching by KevinMD

Health IT will provide job security for the foreseeable future 4 comments

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MIS Prof

With respect to the number of trained IS/IT professionals, it’s going to get much worse before it gets better. The research cited in the article and several other articles and unpublished studies indicate that we really don’t have enough students in the U.S. pipeline (community college, university, and trade schools combined) or enough in the H1B visas allotments to come anywhere close to meeting the projected need over the next five years (in general, not just in health care).

From the late 1990’s to around 2005 there was a 50% drop in enrollment in IS/IT programs around the country. Part of that was due to the dot-com crash, but most of it was due to the rise in off-shore outsourcing of programming work. The percentage of women as compared to men enrolled in training programs has dropped significantly, too. Smart students didn’t see a future for themselves in this field, although high-salaried jobs in systems analysis, security, and network administration have continued to be available. As a result, the number of IS/IT faculty has also been cut. We’ll have trouble ramping up to meet the need. We are now going to suffer the consequences of this phenomenon.

While there have been some slight increases in enrollment since then, many students are not generally drawn to IS/IT training and many are not prepared for the rigor required. In some cases, parents and counselors are actually advising college freshmen away from an IS/IT career. They haven’t gotten the word about the current shortage of trained professionals in this field.

In some cases, students lack the necessary math skills, self-discipline, and persistence to complete a degree in this field. They come to college completely unprepared for the coursework. They may start a degree in information systems or computer science, but they switch majors once they hit the more demanding courses.

Some students have a great work ethic, but they apply this energy to the wrong things. They work so many hours that they don’t have the energy to do the studying and homework this field requires. (I’m sure MD’s can relate to what it takes to pass demanding courses and the need for that coursework to be rigorous.)

With respect to students working more hours, I know that college costs have increased significantly, but I also notice that a lot of students have the latest iPhone with the most expensive data plan. They have the latest, best gaming computers and spend hours playing these online games.

These students think of themselves as technologically sophisticated because they use the hottest forms of technology for communication and entertainment. However, when it comes to learning how these systems work and what it takes to create or implement them, suddenly, the interest vanishes.

I describe this subset of people because they may seek employment by presenting themselves as technologically sophisticated, particularly in an environment of high unemployment. If there are not enough properly trained IS/IT professionals, employers may be tempted to hire anyone who can speak technological jargon and who seems to be an adequate substitute.

Don’t be fooled. People who do not have professional training will likely develop or implement systems that are glitchy, do not have adequate security, integrity, and backup-features, cannot handle the transaction load, and cannot be efficiently maintained. Worse still, they will likely move on to other jobs before many of the problems surface.

There are some things health professionals can do to improve the situation. In the short-term, develop relationships with local information systems departments. (Or computer science departments … but their students may need significant additional training in business processes. I have degrees in both fields, so I can speak to that.) The faculty can connect you with students who have completed formal training as well as identify the best students (give you a chance to cherry-pick). Create scholarships that allow students to work fewer hours and concentrate on their studies.

Work with faculty to create internships to improve the training and attract students to your particular industry. Internships don’t have to be paid if the work is relevant to the degree and the student has faculty supervision and is getting college credit. But it helps to pay interns; payment increases the perspective that their work in the field is valuable.

In the long run, do what you can to spread the word about jobs available for those with appropriate training. Do what you can to improve rigor in your local school districts. Do what you can to give women the impression that they are welcome in this field, too.

Still, it will take more than five years to work our way out of this hole (average degree completion time is five or six years). We might be able to do it in less time if we open the visa gates dramatically wide. If we do, a significant portion of these immigrants will be inadequately prepared, too. (Other countries don’t have their pipeline full enough either.) That approach will also likely gut our own infrastructure for producing enough well-trained professionals.

(By way of disclosure, I have a Ph.D in field and 30 years experience as a university professor in information systems and computer science.)

As in any IT implementation, the key to a successful EMR implementation is going to be a strong, dedicated project manager and functional user representation, such as some type of “physician champion” and other heavy users (like an office manager). Other key IT resources needed will likely include application support personnel and application trainers. Consideration needs to be given to items like work-flow analysis and redesign, hardware installation, software configuration, facility modification, developing a backup system, entering old data, training, and dealing with paper files. Most health care organizations will have some internal resources they can leverage, but it’s likely that additional project support will be needed. Reputable IT staffing and consulting firms can provide the talent to fill in the gaps until the EMR system has been successfully implemented.

What we are really short of, is people who have both clinical experience and programming knowhow. These folks are rare, and worth their worth in gold; but they are disregarded by HR and IT folks, since they wasted all that time learning how physicians do their work, rather than programming new video games. And that’s why our EHR systems all look like something made by somebody who programs video games and never worked in healthcare.

Ever since the EMR incentives started my phone has been ringing a lot more often with people needing to meet the Meaningful Use guidelines before use. A hard part for the IT people is often the doctors want the benefits and the incentives, but some are not ready to embrace the change that it requires in their daily life. However, the doctors that embrace the change often find themselves with more money and more time on their hands, with happier support staff too.